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Vice President, Customer Service Operations

2 months ago

Baton Rouge, United States Bcbsla Full time

Vice President, Customer Service Operations

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. POSITION PURPOSE The Vice President of Customer Service Operations is accountable for the effective management and performance of the customer service departments across all lines of business. This role is responsible for establishing departmental strategic objectives, ensuring that customer service operations are executed in a high quality, repeatable and efficient manner and leading initiatives to continuously improve processes and associated systems. The individual in this role ensures that policies, procedures and contract agreements are implemented and maintained and coordinates customer service activities across the company to ensure accurate resolution of customer inquiries. This role will have accountability for the successful initiation, management and completion of corporate and divisional projects sponsored by customer service. Accountable for complying with all laws and regulations associated with duties and responsibilities. NATURE AND SCOPE Manages People This role directly manages workers This role directly manages these jobs: DIRECTOR, CUSTOMER SERVICE; DIRECTOR, TECHNOLOGY CUSTOMER SERVICE This role reports to this job: SVP, BENEFIT OPERATIONS Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with: All levels of BCBSLA staff and management up to senior management regarding customer service issues The Blue Cross Blue Shield Association to represent the interests of the plan in collaborative meetings and work groups. Subscribers, group leaders, providers, benefit consultants and other Plan personnel to address general and specific claims processing/contract information The Louisiana Department of Insurance and other State agencies to address regulatory and compliance issues when called upon Vendors and consulting partners to negotiate contracts and address company requirements QUALIFICATIONS Education Bachelor's in business, finance, or a related field is required Master's in MBA or related field is preferred Four years of related experience can be used in lieu of a Bachelor’s degree. Work Experience More than 10 years of leadership experience is required. 5 years of healthcare operations management is required. Healthcare insurance experience is preferred. Experience can run concurrently Skills and Abilities Must be professional and proactive with evidence of strong analytical, decision-making, communication and human resource management skills and experience interpreting a strategic vision into an operational model. Demonstrated experience in selecting and managing significant vendor relationships. Experience in the insurance or health care industry preferred. Experience in managing and improving customer service delivery leveraging process design as well as implementing technology solutions. Experience with Six Sigma, TQM or other business process improvement methodology is preferred Ability to successfully complete complex projects and influence change in a complex, fast-paced environment is required Must have demonstrated experience establishing, maintaining and leveraging current market contacts. Must be an effective communicator at all levels in the organization with strong oral, written and presentation skills with willingness to share information and collaborate. Demonstrated effective interpersonal, customer service and relationship building skills is required Must have demonstrated experience setting departmental strategy, communicating and influencing impact and progress to senior leadership. Previous experience working with C-suite executives strongly is preferred Licenses and Certifications None Required ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS Ensures effective management of the Customer Operations departments, which results in accurate, timely and efficient service to members and providers Holds line of business directors accountable for achievement of operational, corporate and incentive goals Represents the company and ensures appropriate attention to the interests of the company relative to work with the Association and other Blue Cross plans Implements a program of continuous improvement aimed toward achieving operational excellence in customer operations across all lines of business Directs, collaborates and leads Divisional Staff to develop, modify, and implement the strategic direction of the division and company. Ensures the meeting of acceptable standards for key Association and operational metrics including but not limited to: MTM score Membership and Billing and Customer Service Local metrics for billing accuracy Local metrics for membership maintenance for membership timeliness Local metrics for customer service Institutes a program of staff development that is consistent with the Division’s core competencies aimed at ensuring continuous improvement in operational efficiency and effectiveness Maintains the budget projections in such a way as to ensure that departmental goals and metrics are met in cost effective way Ensures that new groups are efficiently and accurately set-up, and ID cards are administered in a timely manner. Ensures that the group renewal process is accurate and timely.

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